Effects of an 8-week FIFA 11+ Neuromuscular Training Program on Biomechanical and Psychological Return to Sport Outcomes in Previously Injured Soccer Players: A Mixed Methods Pilot Study

Abstract

Athletes returning to sport following serious musculoskeletal injuries often demonstrate persistent biomechanical deficits and psychological barriers that may increase reinjury risk. The FIFA 11+ neuromuscular warm-up program has demonstrated injury prevention benefits in healthy soccer populations; however, its role during return-to-sport rehabilitation remains underexplored. To examine the effects of an 8-week FIFA 11+ neuromuscular training program on biomechanical and psychological return-to-sport outcomes in previously injured soccer players. This pilot mixed-methods study included 24 competitive university-level soccer players aged 18–30 years with a history of lower-extremity injury and medical clearance to return to training. Participants were randomly assigned to either a FIFA 11+ intervention group (n = 12) or a control group (n = 12). Quantitative assessments included the Drop Vertical Jump Test, Single-Leg Landing Test, Y-Balance Test, Single-Leg Hop Test, ACL-Return to Sport after Injury (ACL-RSI) scale, and Tampa Scale of Kinesiophobia (TSK-11). Semi-structured interviews were conducted before and after the intervention and analyzed using thematic analysis. Compared with the control group, the intervention group demonstrated improvements in landing biomechanics, dynamic balance, limb symmetry, psychological readiness, and reduced fear of reinjury following the 8-week intervention. Qualitative findings suggested improved movement confidence, greater perceived readiness to return to sport, and reduced fear during sport-specific activities. The FIFA 11+ program may support both physical and psychological aspects of return-to-sport rehabilitation in previously injured soccer players. Larger randomized longitudinal studies are required to confirm these preliminary findings.